HomeMy WebLinkAboutT14N R1W SEC 8 SW4SW4NW4T14N R1W
Sec.8
5W4 5W4 NW4
#050-013-01
GAAB-HD-1
GRATER ANCHORAGE AREA BOROISH
HEALTH DEPARTMENT up
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION- REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
Ate %d %S », i
LOCATI ON04/ &.g&
SEPTIC TANK;
DISTANCE FROM WELL /JZ%
MATERIAL
LIQUID CAPACITY moo
GALLONS.
37 4/4144/O�,E��
MAILING
ADDRESS ��� PHONE
C /12/1:g111 "1/8 �/
LEGAL DESCRIPTION
S/2 cfbty /.
00,tle,v
7 Wet //a ct
INSIDE LENGTH
N IF
COMPARTMENTS
'cep 7'�.v4-
X Ce
5, M
1411/41
LIQUID
INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER. OF PITS
LINING MATERIAL
NEAREST LOT. LINE
SEEPAGE PIT:
' .OUTSIDE DIAMETER OR WIDTH
j r4 ve.�
4,0`•
DISTANCE FROM WELL
�,• a'
LENGTH JPO DEPTH
YsZ - BUILDING FOUNDATION_ -
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
3810
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION
TOTAL LENGTH
NEAREST LOT LINE OF LINES
NUMBER OF. LINES DISTANCE BETWEEN. LINES TRENCHWIDTH - IN TOTAL EFFECTIVE
ABSORPTION AREA - SQ FT LENGTHOF EACH LINE - -
DEPTH: TOP OF TILE TO FINISH GRADE �i17 DEPTH OF FILTER MATERIAL BENEATH TILE IN ABOVE TILE
WELL: p /i/ - DISTANCE FROM ' in 1, WATER /1/0
TYPE .}7) e 1 LL 6,D DEPTH
, BUILDING FOUNDATION fJV . SAMPLE NEAREST
LOT LINE SC' t' SEWERST DNE /SD TANK /3��/SYS EM SEEPAGE /-7C,rn / CESSPOOL SOOURCES_
DISTANCES:
_54ow Al
DIAGRAM OF SYSTEM
DATE
APPROVED
HEALTH AUTHORITY
GRAB -HD -2
GREATEaNCHORAGE AREA *ROUGH Case No. /0/
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
/�pp ilm/w v eF
NAME OF APPLICANT ,,qq -2911 F-r�SSistit) MAILING ADDRESS &X3 7 PHONE NO 'QS //
RESIDENCE ADDRESS 61-er ie I t . LOCATION OF INSTALLATION rvL --
LEGAL DESCRIPTION 5ec g /UV yz
APPLICATION TO INSTALL: SEPTIC TANK V , SEEPAGE4.-'-- PITDRAIN FIELD OTHER
TO SERVE THE FOLLOWING FACILITY 3 Le/2,44.7J
FINANCED THROUGH 6o_f TO BE INSTALLED BY l,6ll 01d Le.
PERCOLATION TEST RESULT 4/4" ANTICIPATED DATE OF COMPLETION g�-�/
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT /
THIS IS TO SERVE AS PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
DISTANCES:
SEPTIC TANK SIZE TYPE SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE APPLICANTS SIGNATURE
ace
onstruction & Concrete Co.
Phone: —St= 62 oz/L-/
Mile 19
Chugiak, Alaska
re° 41A -1/ 44 6) 11: I / 1/UC
Ms -maid /Joy- /
fic.../24.0%.
CAter-er
'322
ST
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.41
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Gk-ATER ANCHORAGE AREA BOROUGh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED: 5/8/7_
INSPECT:
TIME:
,00
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
1. APPROVAL REQUESTED BY:
ADDRESS:
PHONE:
yr
///i v&/ /v,o4mom.)
F`5 U't� 42 %
69Ll- 22 9
2. PROPERTY OWNER: diff.' PHONE:• y9a.//97EL/
5, /77,s, ' kc 514 hili/
i
STREET: , ljy/ft_
3 o /r/ , /P, h -0a%
3 /70' —7.7
/d 7
6t t �/�
3. LEGAL DESCRIPTION:
4. TYPE FACILITY TO BE INSPECTED:f/�
NUMBER OF BEDROOMS: %%//
5. WELL DATA:
A. TYPE
8. DEPTH
C. SIZE.
D. CONSTRUCTION weft c --P ois(Glyi
ol
E. BACTERIAL ANALYSIS
6. SEWAGE DISPOSAL SYSTEM:
A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
1. SIZE
2. A.GEJ /'6J
Or�U "4V67/7) J
3. MANUFACTURER
4. INSTALLER
,O, / /4
7t69
M
APPROVAL REQUEST—FOR SEWER & WATER FACILITIES"
PAGE TWO
B. SEEPAGE PIT
1. SIZE /1q)(29 vi r
2. LINING61,-n. C/ce%e ri h�ji
C. DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LEN TH
7. REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK 190f
B. WELL TO SEEPAGE PIT /30t
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE
E. WELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK
G. FOUNDATION TO SEEPAGE PIT
•/
H. SEEPAGE PIT TO PROPERTY LINE 2-0--+
8. COMMENTS:
StAPPROVED. ifG 1 tSW, DISAPPROVED:
DATE: 3 / � 77 Z DATE:
APPROVAL VA ID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY